Procedure X-Ray

Capturing the Essence of The Wound Care Evalution

Documentation in wound care is critical for reimbursement. To ensure payment, a comprehensive individualized plan, indicating the wound problem and goal of treatment must be in the medical record. The American Physical Therapy Association’s (APTA) “Guide to Physical Therapist Practice” recommends the five-stage management system; examination, evaluation, diagnosis, prognosis, and intervention.

Wound care is usually best performed by a team of experts. Your team may consist of any combination of diabetic educators, dieticians, nurses, nurse practitioners, occupational therapists, orth



Compression Therapy: Inside the Wrap

Mr. RU Swollen is referred to your clinic from his primary care provider. He walks into the clinic with an antalgic gait then rests in the waiting room. On examination, both lower extremities are edematous, the left greater than the right. He has purulent draining ulcers over the left foot and leg as well as the right leg. Pedal pulses are weakly palpable and his blood glucose level is 196 mg/dL. Should this patient receive compression for his lower extremities?
Compression therapy is considered a standard of care for chronic venous insufficiency (CVI) patients. A wound care practitioner’s



The Clinician's Role In Compression

Lymphedema, a disorder of the lymphatic system, affects at least 3 million Americans.1 The lymphatic system plays a role in both immune function and circulation. The system is comprised of lymphatic vessels located just under the skin and lymph nodes in areas around the neck, axilla, and groin. As the vessels transport fluid away from the tissues, waste products, bacteria, and large protein molecules are collected. The fluid is carried to the lymph nodes where the water products are degraded and eliminated, while the remaining protein-rich fluid is transported to the heart and back into circul



Centrifugal Debridement Using Advanced Surgical Technology

Modern literature on debridement initially centered on the life-saving benefits of debriding wounds sustained during war. The impact of debridement on decreasing war wound-related mortality was so profound that a century ago the concept of radical debridement became a dogmatic imprint on surgical mentality that has only recently been challenged.1,2

Traditional surgical debridement involves a centripetal technique: extirpation of the wound including a margin of healthy tissue. The goal of surgery is to eradicate all necrotic tissue and debris. In some wounds, which may track subcutaneously,



Going It Alone: Educating Staff as an Independent

Education is a never-ending process of acquiring knowledge and skills and developing powers of reason and judgment. In an independent wound clinic, educational responsibilities are handled in-house. The following discussion offers insights into the way one independent wound clinic, the Archbold Center for Wound Management, Thomasville, Ga, addresses staff educational and training needs.

Background. Our wound care program consists of an outpatient clinic where patients are seen both for MD appointments as well as regularly scheduled wound care. We also consult on acute care patients with c



The Debridement Dilemma

A chance to cut is a chance to cure. — Medical proverb

Non-viable (necrotic) material within a chronic wound has been shown to inhibit the development of vascular tissue (granulation) and the formation of skin (epithelialization). Devitalized material enhances bacterial growth while at the same time decreasing resistance to infection. The removal of such material is called debridement.

General consensus dictates that devitalized tissue should be removed from non-healing wounds (rare exceptions may include eschars on ischemic feet). In a randomized controlled trial of becaplermin, Stee